RIGA - A strike over wages initiated by anesthesiologists at the beginning of November has dramatically slowed the number of surgical procedures being performed in Latvian hospitals, hitting especially hard in Riga. Some operating rooms are carrying out as little as one operation a day.
Despite the anesthesiologists' demand for an increase in wages, a solution is unlikely to be found until more money is pumped into the ailing health-care system. And the recent fall of the government makes any sort of quick fix to the problem even more improbable. The continued strike means that surgery is only being performed in emergency cases, and even those who have the resources to pay are being forced to join an ever-growing line.
At the heart of the problem are the notoriously low wages received by doctors. Many doctors earn only 220 lats (320 euros) a month before taxes, which falls to 170 lats after tax deduction. Hospitals are, in general, largely underfunded, leading many to use up their budgets barely half way through the year. The low wages have also led to a chronic braindrain in the medical field, as qualified nurses and doctors leave Latvia en masse for other countries looking for better remuneration.
Health Minister Rinalds Mucins met with hospital heads on Nov. 9 to discuss the current debacle and a sorely needed increase in funding.
"It is obvious that the current situation is very bad. Today we can have only one, and in the best-case scenario, two surgeries a day, and only in emergency cases. Unfortunately we have a lot of people waiting in line. Right now the earliest time that people can sign up for surgery is May, 2005," a spokeswoman for Romans Lacis, head of cardiology at Riga's Pauls Stradins University told The Baltic Times.
"We are waiting for an agreement between hospitals and nurses so that work can begin again. As of right now only the hospital in Ventspils has returned to normalcy after they agreed to an increase in salary," said Antonina Sondore, head of the Latvian Anesthesiologists and Intensive Care Association.
She added, however, that talks were ongoing and she hoped agreements could be reached shortly in other hospitals as well.
But even the agreement in Venstpils is only temporary, as it runs until the beginning of next year. "What will happen on January 1 is not clear," Valts Rauhvargers, a Ventspils anesthesiologist, told the Latvian daily newspaper Diena.
Finding a long-term solution to the problem will clearly require some considerable state investing, something that, up to now, it has adamantly maintained it cannot afford to do.
"We submitted a budget proposal for a 15 percent increase, but it was rejected," said Zaiga Barvida, head of the communications department at the Health Ministry. "Money is not the only way to solve the problem, we also need better planning," she added, saying some of the waiting list problems could be alleviated through a better program.
The surgery waiting list for those without private funds was already long due to the chronic underfunding of the state healthcare system. Presently, state funds for surgery do not cover the whole cost of an operation. But this latest crisis is affecting even those with private medical insurance.
"We are performing two to three surgeries a week now, when before the strike, we were doing that many a day," a surgeon at Pauls Stradins University hospital said.
The hospital has been unable to perform all its planned operations due to a shortage in funding, and the state money allocated does not even cover needed costs, he said. The hospital has already spent its budget for the year, despite being 2 million lats in debt.